Think a patient needs a follow-up visit? See them in person first

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Patients who see a specialist in person are more likely to have in-person follow-up appointments than those seeing specialists via telehealth, according to new research from EHR manufacturer Epic.

Epic researchers examined millions of records from specialists and primary care providers. They found that in 16 of the 24 specialties analyzed patients were more likely to get a second appointment within 90 days after seeing a doctor in person than in a telehealth visit. For health systems and medical practices, the study suggests that telehealth appointments in specialties don’t automatically lead to office visits.

The biggest disparity was in mental health appointments, according to Epic researchers. For mental health visits, patients who saw a doctor in person were 30% more likely to get a follow-up appointment than those who saw a provider virtually. Moreover, only 10% of telehealth mental health visits had a follow-up appointment in 90 days, compared to 40% of in-person mental health visits.

Patients who saw specialists in physical medicine and rehabilitation and pain medicine were at least 20% more likely to have a follow-up appointment after an in-person visit. Similarly, patients who saw podiatrists and ob/gyn specialists were more likely to have a follow-up appointment with a telehealth appointment.

However, the gap between office visits and telehealth appointments closed significantly when it came to primary care. Patients who saw a family medicine physician were narrowly more likely (0.2%) to have a follow-up appointment after an in-person visit. Patients who saw a pediatrician and an internal medicine physician virtually were slightly more likely to have a follow-up appointment (0.8% and 2.1%, respectively).

It’s worth noting that in many specialties, patients are more likely to see a provider in person, Epic says. In 2022 and early 2023, mental health and sleep medicine were the only two specialties where at least 20% of appointments were done via telehealth.

Epic says researchers examined more than 40.6 million specialty appointments and 32.1 million primary care visits from January 2022 to March 2023.

In recent months, Epic has produced other studies offering evidence that telehealth appointments aren’t necessarily predictors of seeing providers in an office.

In most virtual appointments for primary care, patients haven’t had a follow-up appointment in person within 90 days, according to research Epic did in March. Similarly, most patients who saw specialists virtually didn’t need an office visit in 90 days.

Jackie Gerhart, vice president of clinical informatics at Epic, said 3hat telehealth is offering patients more options for a host of different specialties.

“We've been surprised at how many different conditions we can take care of through telemedicine that we hadn't thought of doing before,” Gerhart said.